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Venous Sampling and Venography: Endocrine, Nonadrenal
T. Gregory Walker, MD, FSIR; Brandt C. Wible, MD
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KEY FACTS

  • Terminology

    • Preprocedure

      • Procedure

        TERMINOLOGY

        • Definitions

          • Inferior petrosal sinus sampling (IPSS): Venous blood sampling from both inferior petrosal sinuses
            • Evaluates for adrenocorticotrophic hormone (ACTH)-secreting pituitary adenoma as etiology for endogenous Cushing syndrome
            • Considered gold standard for confirming origin of ACTH secretion in Cushing syndrome
          • Pancreatic endocrine tumors: Arterial stimulation and selective venous sampling (ASVS)
            • Used for preoperative localization of pancreatic endocrine tumors
              • Evaluates for gastrinoma, insulinoma, VIPoma, glucagonoma, somatostatinoma, pancreatic polypeptide-producing tumor (PPoma)
          • hyperparathyroidism: Selective venous sampling (SVS): Sampling from veins draining parathyroid gland for parathyroid hormone (PTH) assay
            • Preoperative localization of functioning parathyroid adenoma that cannot be localized by imaging
              • Negative/inconclusive imaging findings; prior noncurative surgery for 1° hyperparathyroidism

        PREPROCEDURE

        • Indications

          • Getting Started

            PROCEDURE

            • Patient Position/Location

              • Procedure Steps

                • Alternative Procedures/Therapies

                  POST PROCEDURE

                  • Interpreting Results

                    • Things to Do

                      • Things to Avoid

                        OUTCOMES

                        • Complications

                          • Expected Outcomes

                            Selected References

                            1. Zampetti B et al: Bilateral inferior petrosal sinus sampling. Endocr Connect. 5(4):R12-25, 2016
                            2. Kunstman JW et al: Clinical review: Parathyroid localization and implications for clinical management. J Clin Endocrinol Metab. 98(3):902-12, 2013
                            3. Okabayashi T et al: Diagnosis and management of insulinoma. World J Gastroenterol. 19(6):829-37, 2013
                            4. Ito F et al: The utility of intraoperative bilateral internal jugular venous sampling with rapid parathyroid hormone testing. Ann Surg. 245(6):959-63, 2007
                            5. Lad SP et al: The role of inferior petrosal sinus sampling in the diagnostic localization of Cushing's disease. Neurosurg Focus. 23(3):E2, 2007
                            6. Lau JH et al: The current role of venous sampling in the localization of endocrine disease. Cardiovasc Intervent Radiol. 30(4):555-70, 2007
                            7. Moriyama T et al: Diagnosis of a case of ectopic parathyroid adenoma on the early image of 99mTc-MIBI scintigram. Endocr J. 54(3):437-40, 2007
                            8. Tseng LM et al: The role of intra-arterial calcium stimulation test with hepatic venous sampling (IACS) in the management of occult insulinomas. Ann Surg Oncol. 14(7):2121-7, 2007
                            9. Eloy JA et al: Preoperative selective venous sampling for nonlocalizing parathyroid adenomas. Thyroid. 16(8):787-90, 2006
                            10. Ogilvie CM et al: Selective parathyroid venous sampling in patients with complicated hyperparathyroidism. Eur J Endocrinol. 155(6):813-21, 2006
                            11. Reidel MA et al: Localization of hyperfunctioning parathyroid glands by selective venous sampling in reoperation for primary or secondary hyperparathyroidism. Surgery. 140(6):907-13; discussion 913, 2006
                            12. Jackson JE: Angiography and arterial stimulation venous sampling in the localization of pancreatic neuroendocrine tumours. Best Pract Res Clin Endocrinol Metab. 19(2):229-39, 2005
                            13. Sung YM et al: Selective intra-arterial calcium stimulation with hepatic venous sampling for preoperative localization of insulinomas. Korean J Radiol. 4(2):101-8, 2003
                            Related Anatomy
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                            Related Differential Diagnoses
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                            References
                            Tables

                            Tables

                            KEY FACTS

                            • Terminology

                              • Preprocedure

                                • Procedure

                                  TERMINOLOGY

                                  • Definitions

                                    • Inferior petrosal sinus sampling (IPSS): Venous blood sampling from both inferior petrosal sinuses
                                      • Evaluates for adrenocorticotrophic hormone (ACTH)-secreting pituitary adenoma as etiology for endogenous Cushing syndrome
                                      • Considered gold standard for confirming origin of ACTH secretion in Cushing syndrome
                                    • Pancreatic endocrine tumors: Arterial stimulation and selective venous sampling (ASVS)
                                      • Used for preoperative localization of pancreatic endocrine tumors
                                        • Evaluates for gastrinoma, insulinoma, VIPoma, glucagonoma, somatostatinoma, pancreatic polypeptide-producing tumor (PPoma)
                                    • hyperparathyroidism: Selective venous sampling (SVS): Sampling from veins draining parathyroid gland for parathyroid hormone (PTH) assay
                                      • Preoperative localization of functioning parathyroid adenoma that cannot be localized by imaging
                                        • Negative/inconclusive imaging findings; prior noncurative surgery for 1° hyperparathyroidism

                                  PREPROCEDURE

                                  • Indications

                                    • Getting Started

                                      PROCEDURE

                                      • Patient Position/Location

                                        • Procedure Steps

                                          • Alternative Procedures/Therapies

                                            POST PROCEDURE

                                            • Interpreting Results

                                              • Things to Do

                                                • Things to Avoid

                                                  OUTCOMES

                                                  • Complications

                                                    • Expected Outcomes

                                                      Selected References

                                                      1. Zampetti B et al: Bilateral inferior petrosal sinus sampling. Endocr Connect. 5(4):R12-25, 2016
                                                      2. Kunstman JW et al: Clinical review: Parathyroid localization and implications for clinical management. J Clin Endocrinol Metab. 98(3):902-12, 2013
                                                      3. Okabayashi T et al: Diagnosis and management of insulinoma. World J Gastroenterol. 19(6):829-37, 2013
                                                      4. Ito F et al: The utility of intraoperative bilateral internal jugular venous sampling with rapid parathyroid hormone testing. Ann Surg. 245(6):959-63, 2007
                                                      5. Lad SP et al: The role of inferior petrosal sinus sampling in the diagnostic localization of Cushing's disease. Neurosurg Focus. 23(3):E2, 2007
                                                      6. Lau JH et al: The current role of venous sampling in the localization of endocrine disease. Cardiovasc Intervent Radiol. 30(4):555-70, 2007
                                                      7. Moriyama T et al: Diagnosis of a case of ectopic parathyroid adenoma on the early image of 99mTc-MIBI scintigram. Endocr J. 54(3):437-40, 2007
                                                      8. Tseng LM et al: The role of intra-arterial calcium stimulation test with hepatic venous sampling (IACS) in the management of occult insulinomas. Ann Surg Oncol. 14(7):2121-7, 2007
                                                      9. Eloy JA et al: Preoperative selective venous sampling for nonlocalizing parathyroid adenomas. Thyroid. 16(8):787-90, 2006
                                                      10. Ogilvie CM et al: Selective parathyroid venous sampling in patients with complicated hyperparathyroidism. Eur J Endocrinol. 155(6):813-21, 2006
                                                      11. Reidel MA et al: Localization of hyperfunctioning parathyroid glands by selective venous sampling in reoperation for primary or secondary hyperparathyroidism. Surgery. 140(6):907-13; discussion 913, 2006
                                                      12. Jackson JE: Angiography and arterial stimulation venous sampling in the localization of pancreatic neuroendocrine tumours. Best Pract Res Clin Endocrinol Metab. 19(2):229-39, 2005
                                                      13. Sung YM et al: Selective intra-arterial calcium stimulation with hepatic venous sampling for preoperative localization of insulinomas. Korean J Radiol. 4(2):101-8, 2003